ICU非发酵革兰阴性杆菌的耐药性调查

Antimicrobial resistance of nonfermentative gram-negative bacilli in ICU

目的探讨医院重症监护病房(ICU)非发酵革兰阴性杆菌对常用抗菌药物的耐药性,为临床医师合理用药提供科学依据。方法细菌培养按照《全国临床检验操作规程》进行;细菌鉴定采用MicroScan AutoSCAN4自动微生物鉴定系统进行;药敏试验采用K-B法,依据CLSI折点判读结果。结果 237株非发酵革兰阴性杆菌中,铜绿假单胞菌(PAE)占50.2%,鲍氏不动杆菌(ABA)占25.7%,嗜麦芽寡养单胞菌(SMA)占14.8%,其他非发酵革兰阴性杆菌占9.3%;3种非发酵菌株对抗菌药物产生了很高的耐药性;PAE和ABA泛耐药菌株检出率分别为17.6%和26.2%。结论 ICU非发酵革兰阴性杆菌的多药耐药性已非常严重,应采取有效措施,遏制细菌耐药性增长的趋势。

OBJECTIVE To approach the antimicrobial resistance of nonfermentative gram-negative bacilli in intensive care unit and provide scientific evidence for clinical reasonable use of antibiotics.METHODS Referring to National Guide to Clinical Laboratory Procedures,bacterial culture was performed.Microscan AutoSCAN4 system was used to identify the strains.The susceptibility testing was performed by KB method and the results were assessed according to CLSI breakpoints.RESULTS Among 237 nonfermenters,Pseudomonas aeruginosa（PAE）,Acinetobacter baumanii（ABA） and Stenotrophomonas maltophlia（SMA） accounted for 50.2%,25.7% and 14.8%,respectively.The other nonfermenters accounted for 9.3%.The susceptibility testing results indicated that high antimicrobial resistance to commonly used antibiotics occurred in three nonfermenters.The detection rates of pandrug-resistant PAE and ABA were 17.6% and 26.2%,respectively.CONCLUSION The multidrug resistance of nonfermentative gram-negative bacilli is very serious in ICU.Effective measures should be taken to prevent the increasing tendency of antimicrobial resistance.